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. 2025 Mar 12:19:847-856.
doi: 10.2147/OPTH.S474942. eCollection 2025.

Multi-Stage Reconstructive Surgery of the Eyeball with No Light Perception After Severe Open Globe Injury

Lyubomyr M Lytvynchuk  1   2 , Makar Ponomarov  1 , Erick Carlos Reyna  1 , Knut Stieger  1 , Monika Andrassi-Darida  1
Affiliations

Multi-Stage Reconstructive Surgery of the Eyeball with No Light Perception After Severe Open Globe Injury

Lyubomyr M Lytvynchuk et al. Clin Ophthalmol. .

Abstract

Purpose: To analyze the visual and anatomical outcomes of multi-stage reconstructive surgery of the eyeball with no light perception (NLP) in patients after severe open globe injury (OGI).

Patients and methods: In this retrospective consecutive case series study, medical records of patients with severe OGI with visual loss up to NLP, who were referred to our clinic between February 1, 2016, and March 30, 2021, were included. The analysis of epidemiologic data, type and severity of OGI, timing and type of surgical treatment, and anatomical and functional results was performed.

Results: Nine patients met our inclusion criteria. The mean age was 52 years (range 34-78 years). Mean follow-up was 24 months (range 1-56 months). Estimated mean best corrected visual acuity (BCVA) was 2.92 LogMAR immediate after trauma, 2.27 LogMAR before reconstructive anterior segment surgery and 2.42 LogMAR at last follow-up. The functional gain after the primary repair was highly significant (p 0.005), but a non-significant gain was seen at the last follow-up. Retina reattachment was achieved in most of the cases (6/7, 85.7%), but these remained silicone oil dependent (5/6, 83.33%). In all cases, it was possible to prevent primary enucleation.

Conclusion: The multi-stage reconstructive surgical approach allowed for saving the eyes and improved the functional and anatomical condition. Despite the severity of OGI and NLP, an early surgical intervention should be considered by experienced surgeons.

Keywords: black diaphragm intraocular lens; multi-stage reconstructive surgery; no light perception; open globe injury; retention sutures; vitreoretinal surgery.

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Conflict of interest statement

Dr Lyubomyr Lytvynchuk is the Advisory Board member for ROCHE, outside the submitted work. The authors have no other relevant financial or non-financial interests to disclose for this work.

Figures

Figure 1
Figure 1
Anatomical results after multi-stage reconstructive surgery in case 3. (A) Ultrasound of the injured eye (B) Slit-lamp photography after surgery for proliferative vitreoretinopathy (PVR) shows silicone oil retention sutures with posttraumatic aniridia (C) Anterior segment OCT shows retention sutures (D) Ultrasound after primary repair shows attached retina (E) Wide field fundus photography after primary repair shows attached retina with triamcinolone acetonide intravitreal (F) OCT shows posttraumatic intraretinal edema (G) Slit-lamp photography after implantation of black diaphragm intraocular lens.
See this image and copyright information in PMC

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